PUBLISHED: 5:10 PM on Wednesday, December 6, 2006
How to...Get a mammogram
Planning ahead will improve annual exams
"Boob lady" - the nickname from some patients makes Nancy Blesch, a certified radiology technician, laugh. She specializes in administering mammograms.

Blesch has been giving X-rays for more than 30 years; she is one of six mammogaphers at Zeeland Community Hospital, and a manager. Each mammographer sees an average of 15 patients a day. They work with women of all ages and abilities, including mentally challenged women and those with kyphosis, a severely curved spine.

Radiology technicians do more than set up and shoot the X-ray images.

They clean and maintain the machines and processors before each day begins, and wipe surfaces with a disinfectant between each patient.

What they can't do is answer the question every woman asks: "Did you see anything?"

"It's not our job to tell patients the results. The physician (radiologist) reads the films," she says. "If the X-ray indicates cancer, the woman's doctor will deliver the results."

If a woman wants to see the X-rays, however, Blesch is happy to show them, though she cautions patients not to interpret what they see, especially if they have fibrocystic breasts.

"You want to know your own body," she says, which includes knowing what a benign fibrocystic lump feels like. Both Zeeland and Holland hospitals have nurses who can teach women how to do breast self-exams.

Blesch offers Sentinel readers these tips on how to get the best mammogram possible:

• The U.S. Food and Drug Administration suggests checking to see that the facility is certified.

Blesch says Michigan is one of the few states that requires FDA, state and American College of Radiology certification.

"Those three entities inspect the machine ... radiologists that read the X-rays and the mammographers," she says.

• Get a mammogram at 35. That image serves as a baseline for all future mammograms to be compared to, says Blesch.

• Even if it hurts, get a mammogram.

"The biggest misconception is that it's so horribly painful," she says.

• For some, the ones with very dense breasts, it can be uncomfortable (for less than a minute). But for most, it's not at all."

• If you have breast implants, say so when making the appointment.Remind the technician when you arrive. Breast implants require extra views, eight instead of the four for most women.

"The implant hides a lot of breast tissue," she says. Every mammographer in Michigan is trained to X-ray breasts with implants.

• Skip deodorant, lotion, powder or perfume the day of the mammogram.

"They can cause shadows on the X-ray pictures and can make them harder to read," she says.

"Some powders have metal flecks and that little bit can give a false reading of microcalcification - when those (dots) cluster, it can be an early sign of cancer."

• Take your doctor's name and address with you so the facility knows where to send results. By law, the facility must also provide the results to the patient within 30 days after the exam.

"Response time is much faster," she says. "If we have someone with a possible cancer, we want to move on it as fast as we can." Having the physician's contact information means reports can be faxed and the patient can be called back more quickly to schedule a second mammogram.

"We know the anxiety; we're women too," she says.

• Plan on 30 minutes for the exam, which includes time to change into and out of the gown. The actual exam takes less than 20 minutes.

• Call for results if you hear nothing within 30 days. Michigan requires patients to be notified in a report written in layman's terms, Blesch says. Mammograms are given the following ratings:

A = normal

B = an abnormality, such as a benign cyst

C = could indicated the facility is waiting on X-ray records from another hospital or institution or that something on the X-ray requires further investigation. In this case, the patient gets a phone call.

"If the lady doesn't want to come back, I call and explain the importance of what has to be done," she says.

• Try to use the same facility each year, so X-rays can be compared quickly and efficiently. If you must change facilities, make sure to transfer the records, which include the original X-rays, to the next facility.

Blesch has never had breast cancer, but says members of her family and at least one close friend have been diagnosed. She says some women are uncomfortable being touched during the exam and offers this advice.

"You've got to remember, when you're having a mammogram, it's not just you taking care of yourself. Its taking care of your daughter, your mother. If you develop breast cancer, everyone around you is affected.

You need to get your annual mammogram. If they find it in you, they can find it quicker in your daughter."

Resources for readers: American Cancer Society,; Susan B. Koman Foundation,; National Breast Cancer Awareness Month,